ANTEIS AESTHETICS SOLUTION

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ANTEIS AESTHETICS SOLUTION

CHANGE STARTS HERE

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ANTEIS · CHANGE STARTS HERE 03

About Anteis Anteis is a leading Swiss innovator in next-generation injectable biopolymers based on hyaluronic acid, with a strong global presence in aesthetic dermatology. The company is active in three medical areas:

Dermatology

Ophthalmology

Orthopaedics

Anti-age treatments, including

Intraocular surgical devices for

Visco-antalgic for the

biodegradable wrinkle fillers

cataract and glaucoma surgery

treatment of osteoarthritis

and skin rehydration gels

With over 2.5 million syringes sold since 2005, Anteis is one of the fastest growing companies in aesthetic dermatology. The company has received numerous awards, including the Swiss Economic Award 2008 in recognition of its innovation, market leadership and quality, and the 2009 Gusi Peace Prize for its contribution to improving people’s wellbeing.

GUSI PEACE PRIZE

At present, Anteis Aesthetics Solution includes 4 distinct product ranges

Esthélis Basic & Soft

Fortélis

Modélis

Mesolis and Mesolis+

Smoothing all types

Filling folds and

Modelling and

Rehydrating and restoring

of wrinkles

deep wrinkles

restoring facial

the skin’s radiance and

volumes

elasticity

In addition, Anteis recently introduced the Anteis Injection System, a breakthrough technology for the highly precise, automated, local injection of gels, with greater comfort for patient and practitioner.

Anteis was founded in 2003 in Geneva, Switzerland and has its own in-house research & development department as well as an ISO-certified manufacturing facility in Lonay-Morges and a FDA-inspected manufacturing facility in Geneva, Switzerland. Anteis is represented in about 90 countries on 5 continents.

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ANTEIS · TECHNOLOGY 04

HA and cross-linking Hyaluronic acid (HA) is a natural component of connective tissue that provides firmness, elasticity and water retention. HA gels are widely used as dermatological fillers and have shown their superiority to collagen thanks to greater safety and longevity.

Phase 1 Addition of pure hyaluronic acid

Because HA in its native form is quickly degraded in the body by enzymes and free radicals, it needs to be cross-linked to provide a long-lasting result. There are many ways to carry out this

CROSS-LINKING

cross-linking, and the clinical results differ widely.

Cross-linked HA gels can be produced in monophasic or biphasic forms. Biphasic gels are an older technology and contain microparticles dispersed in an aqueous carrier. They do not integrate Phase 2

so well into the skin and have a higher risk of causing side effects

Linearisation of hyaluronic acid

such as granulomas and hypersensitivity. Monophasic gels are uniform and contain no particles, and they have proven to be superior to biphasic gels for their safety and ability to integrate into the skin’s extracellular matrix. Anteis exclusively uses monophasic gels in its product range, using biofermented (non-animal origin) HA. Phase 3 First cross-linking of hyaluronic acid through the addition of BDDE

Anteis’s unique technology Dynamic cross-linking is a process patented by Anteis combining different density levels – polydensification – within a monophasic product. Anteis’ fillers are the only ones on the market being

DY N A M I C C R O S S- L I N K I N G

monophasic and polydensified.

Phase 4 Pulling of the first cross-linked level

Phases 1 to 3 The cross-linking procedure, based on these first three phases, has long been known. It was patented 20 years ago and is currently used in the manufacture of most of the other NaHa-based resorbable implants.

Phase 5

Innovative phases 4 to 5

Continuation with a dynamic second cross-linking with a supplementary addition of hyaluronic acid

These last two phases constitute the innovative part of the dynamic cross-linking technology patented by Anteis.

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05

Dynamic Cross-Linking Technology

Smoothing

Filling

Modelling

CPM

EVE

HPM

Cohesivity

Elasticity

Plasticity

Sub-cutis

Intradermic

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Cross-linking rate

Polydensification

The advantages of Anteis’s dynamic cross-linking technology are substantial and of great significance: • The denser parts contribute to a longer-lasting result.

• The less dense parts make the gel easy to inject and enable it to be homogeneously integrated into all layers of the dermis.

• The result looks and feels natural.

• The products are very safe, with minimum side effects.

Anteis employs its dynamic cross-linking technology throughout its range of dermatological filler products and has achieved extraordinary results. Comparative clinical studies on volunteers have shown that Anteis’s monophasic polydensified HA gels are very forgiving, producing less clumping and a more homogeneous distribution than either the biphasic gels or monophasic monodensified gels commonly used by competitors.

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ESTHÉLIS · UNMATCHED WRI NKLES SMOOTHING & SU R 06

Esthélis is an injectable gel using Anteis’s dynamic cross-linking technology, intended for: • Filling all types of wrinkles

• Enhancing lip volume and contours

• Smoothing fine lines

• Correcting sunken scars

Esthélis comes in two highly purified forms:

Esthélis Basic

Esthélis Soft

• Superior level of HA

• Low level of HA

cross-linking (22.5mg/ml)

cross-linking (20mg/ml)

• For all types of wrinkles

• For fine lines

• Superficial to mid-dermis injections

• Superficial injections

Esthélis is the only highly cross-linked gel that allows: • incomparable dermal integration

• very superficial injection

• the most natural results

• use of less product

• minimal risk of side effects

• long-lastingness

This unmatched capacity is the result of cohesive polydensified matrix (CPM) technology, developed and patented by Anteis.

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U RFACE TREATMENT 07

Esthélis provides very natural-looking results with a homogeneous integration into the skin

CPM: Esthélis

Competitor 1

Competitor 2

Monophasic polydensified

Monophasic monodensified

Biphasic

Smoothly surfaced block

Not smoothly surfaced block

With micro-particles

without particles

Esthélis can be injected very superficially, requiring very little product. It maintains its volume for the first months after injection, making touch-ups and over-corrections Esthélis Basic

unnecessary, and has an average duration of 9 months, often lasting over a year.

Esthélis has a remarkable safety record, with not a single hypersensitivity reaction recorded nor any granulomas observed since its launch in 2005.

HA distribution in the dermis*

Control

114 days after injection of HA fillers, Alcan blue staining · Violet = HA

Anteis

Competitor 1

Competitor 2

Monophasic polydensified

Monophasic monodensified

Biphasic

The comparative biopsies demonstrated that: • Esthélis infiltrated the dermis homogeneously • Esthélis produced minimal dermal trauma or structural alteration

* Title of the study: "Distribution and biological effects of a monophasic polydensified cross-linked HA filler compared to monophasic-monodensified and biphasic gels injected in human dermis" · Investigators: Salomon D, Tran C, Micheels P, Gtand D, Carraux P · Study period: June 2007 - April 2008 · Number of patients: 15

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FORTÉLIS · EXTRAORDI NARY FI LLI NG & LI P VOLUME A 08

Fortélis is a resorbable gel with remarkable volume-enhancing power, intended for: • Filling deep wrinkles, folds and facial depressions • Increasing lip volume

Fortélis features Anteis’s patented cross-linking technology and is designed to provide Extra Volumizing Elasticity (EVE).

Developed with a carefully defined cross-linking ratio and a

Fortélis resorbable gel

high concentration of HA (25.5 mg/ml), its level of elasticity is perfectly adapted for enhancing volume and filling deep wrinkles while benefiting from all the advantages of a monophasic fluid gel. Fortélis achieves its best results when injected into the deep dermis, maximizing the natural effect and avoiding possible defects in appearance. The results can last for up to a year.

Fortélis is extremely safe and has excellent tolerability: • Minimum inflammatory reactions observed • Low degree of immune reactivity

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AUGMENTATION 09

Excellent tolerability compared to other products A comparative clinical study* showed on a histological level the local reactions to injected resorbable HA-based gels:

L and P

L, P, eG

L

L and P

P

No blood cells

D30

Anteis

Competitor 1

Competitor 2

Competitor 3

Monophasic polydensified

Monophasic monodensified

Monophasic monodensified

Biphasic

• Histomorphologically

• Slight to moderate degree

• Severe chronic

• Severe chronic

of chronic inflammation

inflammation

inflammation

free from inflammatory

• Increased number of

reactions • Unremarkable immune reaction

• Dense infiltration of in

lymphocytes & plasma cells

flammatory cells (lympho-

and several granulocytes

cytes and plasmocytes)

• Dense infiltration of lymphocytes, plasmocytes & granulocytes

• Regular distribution

• Uneven distribution

• Uneven distribution

• Uneven distribution

of foreign material

of foreign material

of foreign material

of foreign material

The findings document no inflammation and a hardly detectable immune response for Fortélis. The remaining dermal fillers induced varying degrees of chronic inflammation as well as significant immune reactions.

Very high patients' and practitioners' satisfaction Between June 2008 and January 2009, a satisfaction survey on Fortélis was conducted on a worldwide scale.

During this period, 175 practitioners evaluated the product and the quality of the results on 1161 patients.

Fortélis obtained an average score of 8.75 out of 10, according to 11 criteria, by the 175 practitioners who participated in the survey, with an even greater appreciation of Fortélis when injected into the lips.

10.0

9.5

9.0

8.5

8.0 General

Folds/deep wrinkles

Lip volume

Contours

Immediate

Easy placement

Integration

Could see immediate

fil./vol. effect

of the implant

into dermis

fil./vol. effect

* Publications: Dr.A.Z.Taufig, A. Szöke,

W.Kühnel (2009) · Neue Strategie zur Erfassung intradermaler Reaktionen

nach Implantation resorbierbarer Dermalfiller · J Ästhet Chir 2009 2:29 – 36 © Springer Medical Publishing 2009

Reliefs

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MODÉLIS · VOLUME RESTORATION & MODELLI NG WITH O 10

Modélis is a resorbable bio-implant intended for: • Restoration of facial volumes (cheekbones, cheeks, temples, jaw, chin, nose) • Sculpting of facial reliefs

Modélis offers outstanding plasticity and malleability, due to its use of HPM (Hybrid Plastic Matrix) technology. With this technology, combined with a high concentration of HA (26 mg/ml), the polydensification process is pushed to the limit to create two extremely different densities of cross-linked gel within a monophasic matrix.

The HPM technology has several key benefits: • The denser parts are almost solid, providing a remarkable long-lasting volumizing effect.

• The less dense parts are cohesive, ensuring the stability of the matrix, an absence of migration of the gel and ease of injection.

• The extreme polydensification process gives Modélis unique plasticity characteristics, allowing the face to be shaped and sculpted as desired.

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H OUTSTANDING MALLEABILITY 11

Modélis HPM Technology Polydensification

Excellent bio-implantation

Very low ejection force

Modélis Rheological Properties & Benefits

Plastic

Elastic

Cohesive

Highly

Very

Long

No migration

malleable

Volumizing

Lasting

of the gel

Modélis allows a very comfortable injection force, even with thin needles or cannulas. It can be easily injected into the deep dermis, subcutaneously or in the upper periostea, and it produces a long-lasting result of up to 18 months.

Due to its cohesiveness, the gel does not migrate, while its elasticity enables it to retain its shape as it is modelled.

Comparison of Modélis with other volumetric fillers Modélis has garnered praise from practitioners, with 100% of those surveyed* considering Modélis to be superior or equivalent to the main competitive products.

Comparison

Volume

Injectability

Placement

60

50%

40

50%

50%

50%

50%

50%

46% 36%

20 18%

* An open label and multi-centre clinical evaluation assessing the efficacy and safety of Modélis, a new hyaluronic acid volumetric medical device dedicated to facial volume restoration. 9 injectors from France, Switzerland, Thailand, Germany and Belgium.

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MESOLIS · REJUVENATION BY REHYDRATION 12

The Mesolis range is specifically designed for rehydration treatments and intended for: • Rehydration and restoration of radiance and elasticity to the skin • Application on the face, neck, “décolleté”, hands Skin rejuvenation treatments with Mesolis are especially indicated for treating damage due to aging as well as environmental pollution, smoking, sun exposure, hormonal imbalances or the side effects of aggressive aesthetic treatments.

The benefits include: • giving radiance, tone and elasticity to tired and dried out skin • smoothing away fine lines • preventing the formation of wrinkles • skin pre-treatment before the injection of fillers to increase the duration of the effect and create a smoother transition with the rest of the face • decreasing fatty mass in the dermis (cellulite)

The Mesolis products contain only ingredients naturally present in the body and come in two forms:

Mesolis

Mesolis+

• Contains HA (14mg/ml)

• Contains HA (18mg/ml) + glycerol, for enhanced rehydration

• For use on younger, less dehydrated skin

• For use on more damaged, more dehydrated skin

Both Mesolis and Mesolis+ use HA with a very high molecular weight, giving them extraordinary water-retaining power. As opposed to the other products in Anteis’s dermatological line, the HA used in the production of Mesolis and Mesolis+ is not cross-linked. It is therefore possible to use these gels with the “multi-puncture” (nappage) and “papular” techniques in the dermal-epidermal junction.

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Glycerol is combined with HA for a long-lasting hydration effect • Glycerol sets up more links between HA chains through hydrogen bonds and creates a more stable matrix that remains longer in the skin.

Hydrogen bonds

Water molecule

Glycerol molecule

Glycerol strengthens the rehydrating power of HA

100.0

• through its own extremely high hydrating properties 10.00 G’ (Pa)

• by reinforcing the stratum corneum in its role as a barrier against water loss

1.000

• through the creation of a “protective mantle” around HA. 0.100

This shield protects it against degradation, in particular through resistance to free radicals, mechanical pressure

0.010 1000 HA with glycerol

2000

3000

time (h)

and thermal variations.

HA without glycerol

A recognized protocol adaptable to your patients’ expectations To guarantee long-lasting results and a high level of satisfaction, Anteis recommends a standardized protocol consisting of 3 first sessions spaced out of 2 to 3 weeks, followed by another session after 2 months and then at intervals of about 6 months. This protocol can nevertheless be revised depending on patients’ objectives: preventing wrinkles, complementing a wrinkle treatment, or benefiting from a simple “flash” of radiance in view of a special occasion. The Mesolis products are highly safe. Secondary effects are considered to be virtually non-existent.

Theoretical hydration level

Theoretical hydration curve during a Mesolis treatment

Day 0

Day 15

Day 30

Day 90

Day 270

1st injection

2nd injection

3rd injection

4th injection

5th injection

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ANTEIS · TRUST THE CONFI DENCE THAT COMES FROM E 14

Before

Before

Before

After

After

After

Indication

Indication

Indication

Treatment of naso-labial folds,

Cheekbones

Complete face wrinkles

eye rings and glabellar lines

treatment

Esthélis

“

I really appreciate the possibility of injecting so super-

result. My patients have been very pleased with

ficially to work very precisely and to get such natural

the results and I am impressed with this product.

…the general ergonomics of the product is perfect.

„

which makes it almost impossible to have a poor

„

and remarkable results. And my patients do applaud

Truly an injectable that is foolproof.

when they see the long-lasting results…

Dr Tibor Harmathy · General Practitioner · Canada

Dr Patrick Micheels · General Practitioner · Switzerland

“

The safest dermal filler available

“

I like using Esthélis because it gives reliable and

predictable results. In my opinion it is the safest dermal filler available and lasts longer than other

„

available products. There is an extremely high level

„

of patient satisfaction, negligible swelling and little post-treatment downtime.

Modélis

Dr Peter Bakaric · Cosmetic Physician · Australia

“

The first time I used it, I immediately appreciated

the fantastic lifting power of Modélis as well as the

“

ease of injection through relatively small gauge

stands out uniquely amongst other injectable

needles and cannulas. The product moulded easily,

hyaluronic acid compounds because of the ease

providing a smooth natural facial contour.

of injection and the unique injection technique

Dr Arthur Swift · Plastic Surgeon · Canada

I am pleased to endorse Esthélis. This product

„

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M EXPERIENCE 15

Before

Before

Before

After

After

After

Indication

Indication

Indication

Treatment of scar

Lip augmentation

Face contours, naso-labial folds and lip enhancement

“

“

I immediately appreciated the fantastic lifting power

Modélis is the volumizing product that gives me

the most satisfaction because it is easy to handle when injecting and it can diffuse in the tissues very homogeneously and very naturally. The quality of

„

the results lasts over the long term just like the patients’ satisfaction.

„

Dr Ghislaine Beilin · Aesthetic Doctor · France

Mesolis · Mesolis+

Anteis Injection System

“

effects of prolonged sun exposure. It really gives

“

my patients’ skin back elasticity and tone. Smokers

to traditional techniques. It offers a very uniform

…Mesolis+ is perfect to compensate for the

I have used the Anteis Injection System for

over a year now and I can’t imagine going back

who have quite ‘tired’ skin recover a radiance they

„

and predictable result with much less pain

haven't had for years…

perceived by the patient.

Dr Katarzyna Kwarecka · Dermatologist · Poland

Dr Ildiko Papp · Dermatologist · Hungary

“

…For dermis rehydration? I certainly vote for

„

Mesolis+. It's been my most positive experience for rejuvenation treatments these last 20 years...

Dr Anne Grand Vincent · Aesthetic Doctor · France

„

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ANTEIS INJECTION SYSTEM 16

The Anteis Injection System is an innovative, automated electronic system that helps to deliver unprecedented results.

Developed after a careful analysis of the key objectives and needs of both practitioners and their patients, it is set to become the new industry standard. The system is suitable for all types of aesthetic treatments based on injectable gels, including the complete Anteis Aesthetics Solution range, and can be used for filling wrinkles and folds, modifying facial shape and volume and rehydrating the dermis.

Launched in 2009, the Anteis Injection System remains a novelty in the aesthetic market. It has proved its effectiveness in reducing pain during injection and also decreasing the amount of bruising, swelling and side effects commonly seen with other injection techniques.*

The Anteis Injection System allows for a very smooth and constant injection of product that does not overstretch the tissues and results in more consistent outcomes.

Key features • Delivers extremely natural-looking results • More homogeneous integration of the gel into the dermis due to a constant pressure • Less pain • Fewer side effects such as bruising, redness and swelling • Fast and easy to install

Advantages for practitioners • Significantly less muscle fatigue brought on by the automated injection process • Better control over the speed of injection • Accurate control of the volumes injected • Unmatched injection precision • Less product needed

* Results of clinical evaluations of the Anteis Injection System (November 2007 – August 2009) 8 injectors from France, Poland, Switzerland, Greece, Hungary, Latvia and Brazil, 193 patients

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The Anteis Injection System consists of three main parts: • foot pedal

• central unit

• hand-piece

It also comes with boxes of ready-to-use syringes adapted to the system.

The easy-to-control foot pedal allows the practitioner to select the way the product is delivered – either continuously, in “flow” mode, or via regular droplets, in “drop” mode – and the size of the droplets or the flow rate.

The Anteis Injection System features breakthrough technology that helps physicians perform treatments more effectively and patients to experience greater comfort.

This unique system was distinguished with an honourable mention for product design by red dot in its 2010 international design competition.

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THE ANTEIS PRODUCT RANGE · FOR A GLOBAL AEST H 18

Esthélis Basic

Fortélis Extra

Needle /

Level of injection

cannula size

HA concentration

Volumes

Product

Esthélis Soft

Manual: 0.6 ml and 1 ml

Indications

Manual: 1 ml

AIS:

AIS:

5 x 1 ml

5 x 1 ml

20 mg/ml

22.5 mg/ml

25.5 mg/ml

30G 1/2

30G 1/2

27G 1/2

27G 1/2

Superficial dermis

Superficial to mid-dermis

Deep dermis

• Fine lines

• Medium to deep wrinkles and

• Folds and deep wrinkles

• Perioral lines

Average duration of results*

Manual: 0.6 ml and 1 ml

volume enhancement

• Reliefs and contours of the face

• Lip commisures

• Nasio-labial furrows

• Lip volume

• Crow’s feet

• Glabellar wrinkles

• Correction of facial depressions,

• Forehead lines

• Lip volume enhancement

• Correction of facial depressions,

• Correction of facial depressions,

either age-related or due to

either age-related or due to

injury (scars...)

injury (scars...)

Up to 12 months

Up to 12 months

* Several factors may influence the duration of the result: volume injected, patient's skin type, injection technique used…

either age-related or due to injury

Up to 12 months

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T HETIC TREATMENT 19

Modélis

Manual: 2 ml AIS:

Mesolis

Manual: 1 ml

5 x 2 ml

Mesolis+

Manual: 1 ml AIS:

5 x 1 ml

26 mg/ml

14 mg/ml

18 mg/ml + Glycerol

25G 1

Manual: 30G 1/2

Manual: 30G 1/2 AIS:

Cannula (manual): 22G 50 mm Cannula (AIS):

32G 1/6

25G 40 mm

Deep dermis

Superficial dermis and

Superficial dermis and

Sub-cutaneous

dermal-epidermal junction

dermal-epidermal junction

• Rehydration and recovery

• Rehydration and recovery

Upper periostea

• Restoration of facial volumes (cheekbones, cheeks, temporal zone, facial contours) • Sculpting

of tired dermis • For use on face, neck, décolleté, back of hands

• “Flash“ radiance heightener • For use on face, neck, décolleté, back of hands

• For facial fat loss (lipoatrophy)

Up to 18 months

of tired or dehydrated dermis

Depending on protocol

Depending on protocol

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DP01-86-01EN

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Anteis has created its own academy for plastic surgeons, dermatologists and aesthetic practitioners: the InjectNow Academy. The InjectNow Academy makes available to practitioners complete information supports on injection techniques and regularly organizes seminars that present injection protocols. For more detailed information on the programs offered and the dates of the next sessions, visit our website: www.injectnow.com

The Anteis InjectNow Academy (INA) – combining technique and technology

Anteis S.A. Chemin des Aulx 18 1228 Plan-les-Ouates Geneva/Switzerland

Tel: +41 (0)848 747 848 Fax: +41 (0)848 949 849 mail@anteis.com www.anteis.com

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